The specific aims of the proposed research are to document and evaluate an Indian-oriented treatment program for alcohol abuse, the Seattle Indian Alcoholism Program, and to compare the condition of clients of this program over a two year period with the condition of: (1) Indians who abuse alcohol but reject treatment; (2) Indian clients of an integrated, i.e., ethnically and culturally diverse, alcoholism treatment program; and (3) Indians who do not abuse alcohol. Building upon ongoing research, the study seeks to continue developing an interdisciplinary informational resource for understanding Indian alcohol abuse and treatment outcome. The methodology makes use of a prospective longitudinal framework. The proposal extends and amplifies the study of four ongoing samples of subjects: (1) Seattle Indian Alcoholism Program clients (n=100); (2) Indians from the King County Detoxification Faclitiy who reject treatment (n=50); (3) Indian clients of King County's Cedar Hills integrated program; and (4) Indians who do not abuse alcohol. Data will be gathered at intake, 3, 6, 12, 18 and 24 month intervals using a protocol of questionnaires and test instruments covering sociocultural background, psychological functioning, family environment, stress, coping, and alcohol use. Treatment outcome will be assessed in terms of decreased alcohol use and improved socio-economic and psychosocial functioning. An ongoing ethnographic study will focus on the treatment settings and the post-treatment social environment experienced by Indians. The interdisciplinary research team has representation from psychiatry, psychology, anthropology, nursing, public health, and statistics; the research also has significant Indian involvement, including Indian participation at all levels on the research team and cooperation with the Seattle Indian Alcoholism Program. The long-term objectives are to provide information that can be used to improve planning and thereby facilitate delivery of health care programs to meet the needs of Indians suffering from alcohol abuse.